Diffusion tensor imaging and voxel-based morphometry study in early progressive supranuclear palsy

¹ Dept of Medical Sciences, Neurology, University of Brescia, Brescia, Italy
² Vita-Salute, San Raffaele University, Milan, Italy
³ Scientific Institute San Raffaele, Milan, Italy
⁴ Ancelle della Carità,Hospital, Italy
⁵ IRCCS, Memory Clinic, Alzheimer Centre, Brescia, Italy
⁶ Neuroradiology, University of Brescia, Brescia, Italy
⁷ Vita-Salute San Raffaele University, IRCCS San Raffaele and INB-CNR, Milan, Italy

^* To whom correspondence should be addressed. E-mail: padovani{at}med.unibs.it.

Accepted 21 October 2005

	Abstract

Background: A comprehensive characterisation of grey and white matter changes in Progressive Supranuclear Palsy (PSP), the second most common extrapyramidal syndrome after Parkinson Disease, is still not available.

Objective: To evaluate grey and white matter changes in mild PSP patients by Voxel-Based Morphometry (VBM) and Diffusion Tensor Imaging (DTI), respectively.

Methods: Fourteen mild PSP patients and 14 healthy controls entered the study, and underwent a clinical and neuropsychological evaluation according with a standardised assessment. Each subject underwent a structural Magnetic Resonance Imaging (MRI) study. Processing analysis of MRI data were performed according to optimized Voxel Based Morphometry, and fractional anisotropy was determined.

Results: In PSP patients compared to controls ,VBM analysis showed a significant clusters of reduced grey matter in premotor cortex, frontal operculum, anterior insula, hippocampus and parahippocampal gyrus, bilaterally. With regard to subcortical brain regions, the pulvinar, dorsomedial and anterior nuclei of the thalamus, and superior and inferior culliculum were affected, bilaterally. A bilateral decrease in fractional anisotropy in superior longitudinal fasciculus, anterior part of corpus callosum, arcuate fascicolus, posterior thalamic radiations, and internal capsule, likely involving cortico-bulbar tracts, was present in PSP patients compared to controls.

Conclusions: The present data provide evidence for both grey and white matter degeneration in PSP, since the early disease stage. These structural changes suggest that atrophy of cortical and subcortical structures and neurodegeneration of specific fiber tracts contribute to neurological deficits in PSP.

Keywords: diffusion tensor imaging, magnetic resonance imaging, progressive supranuclear palsy, voxel-based morphometry

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